Mood Stabilizers
The medications represented by DOG TLC.
What are Divalproex, Oxcarbazepine, Gabapentin, Topiramate, Lamotrigine, and Carbamazepine? (Mood stabilizers/AEDs)
The therapeutic range for serum lithium.
What is 0.4-1.4 mEq/L?
The eight benzodiazepines used to treat anxiety disorders.
What are alprazolam, triazolam, clonazepam, oxazepam, temazepam, lorazepam, and chlordiazepoxide?
The reason that benzodiazepines are used short term and PRN only.
What is there is an increased risk for physical dependence and tolerance?
This antidote for benzodiazepine overdose is hardly used because it can cause withdrawal and seizures in the patient.
What is flumenazil?
These are the indications for mood stabilizers/AEDs.
What are bipolar disorder, mania, and concurrent use with lithium?
The signs and symptoms of lithium toxicity.
What is LITHIUMS/CANHAMSUCS? (LITHIUMS: levels, increased urinatin, thirst/tremor, hair loss/hypothyroid, impaired memory/interactions, upset stomach, muscle weakness, skin conditions; CANHAMSUCS: confusion, an increase in urine and thirst, nausea, hand tremors, ataxia, muscle twitches, seizures, uncontrollable eye movements, coma, seizures)
The indications for the atypical anxiolytic buspiridone.
What are anxiety, panic disorder, OCD, PTSD, and to decrease bruxism?
These are common side effects of benzodiazepines.
What are drowsiness, sedation, decreased concentration, impaired memory, clouded sensorium, and decreased coordination (ataxia)?
Kava kava is an herb that is used to treat anxiety and insomnia, but it can cause this adverse effect.
What is risk of liver damage?
The mechanism of action of AEDs.
What is prevents seizures by slowing the entry of Ca and Na back into the neuron, which decreases seizures by enhancing the inhibitory effects of GABA?
These labs are important to monitor for a patient who is taking lithium.
What are TSH, BUN, and Creatinine?
The benefits of buspiridone over benzodiazepines in anxiety treamnet.
What is buspiridone does not interfere with daily activities, there is no sedation, dependency is unlikely, and it can be used long-term?
Decreased hepatic and renal function causes an increased risk for toxic effects of benzodiazepines. That is why a lower does is needed in this population.
Who are the elderly?
The two sedating antihistamines.
What are hydroxyzine and diphenhydramine?
This AED can cause a serious rash that may require hospitalization, making it important to monitor the patient's skin.
What is lamotrigine?
These substances should be avoided when taking lithium.
What are NSAIDs, ACE inhibitors, diuretics, and hydrochlorothiazide?
The mechanism of action of benzodiazepines.
What is potentiates the inhibitory effects of GABA which causes CNS depression?
Benzodiazepines fall into pregnancy catgory D (teratogenic), meaning that they cause definite adverse effects to the fetus. That is why the patient is encouraged to use this medication.
What is contraception/birth control?
The common side effects of sedating antihistamines.
What are anticholinergic side effects, sedation, drowsiness, lethargy, and CNS depression?
When patients are taking gabapentin, it is important for them to avoid doing this.
What is operating heavy machinery?
When a client has lithium toxicity, these actions are important for the nurse to perform.
What are rapid assessments (check VS and LOC), hold all lithium doses, ↑ hydration (5-6 L/d) NS to promote excretion, gastric lavage → ↓ lithium levels (levels <2.1), and hemodialysis for levels >2.5?
These benzodiazepines are also first line medications for seizures.
What are lorazepam, diazepam, and midazolam?
Important patient teachings for benzodiazepine use.
What are do not operate heavy machinery, do not use with alcohol, avoid use in pregnancy, Use short term only, and do not stop abruptly because stopping abruptly can lead to withdrawal seizures?
The common side effects of buspiridone.
What are dizziness, lightheadedness, nausea, headaches, and agitation?